scholarly journals Cerebrovascular Accident Complicating Diabetic Ketoacidosis in a Nigerian Adolescent: A Case Report and Review of the Literature

2021 ◽  
Vol 7 (4) ◽  
pp. 410-414
Author(s):  
IJ Akinola ◽  
G Akinyosoye ◽  
SA Adedokun
Keyword(s):  
Case Report ◽  
Diabetic Ketoacidosis ◽  
Cerebrovascular Accident ◽  
Vascular Reactivity ◽  
Cerebral Oedema ◽  
Neurological Complication ◽  
Coagulation Factors ◽  
Paediatric Population ◽  
Review Of The Literature ◽  
Cerebrovascular Accidents

Cerebrovascular accident (CVA) is a rare neurological complication of diabetic ketoacidosis (DKA) in the paediatric population. The risk of developing CVA in DKA patients is often increased due to abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. Cerebral oedema, the most common neurological complication of DKA, may also predispose to CVA. We report the case of a -12-year-old adolescent with DKA complicated by CVA. She developed features of right hemispheric CVA while on admission and had radiological confirmation of an ischaemic CVA. This report highlights that cerebrovascular accidents in DKA can easily be missed or confused with cerebral oedema.

scholarly journals Tacrolimus-induced Diabetic Ketoacidosis in a Polymyositis Patient Precipitated by Fluconazole: A Case Report and Review of the Literature

2020 ◽  
Vol 8 (3) ◽  
pp. 76-78
Author(s):  
Hira Chaudhary ◽  
Shweta Kumar ◽  
Nagasudha L Chigurupati ◽  
Gregory A. Chang ◽  
Gul Bahtiyar ◽  
...  
Keyword(s):  
Case Report ◽  
Diabetic Ketoacidosis ◽  
Review Of The Literature

scholarly journals Diabetic Ketoacidosis-Associated Stroke in Children and Youth

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Jennifer Ruth Foster ◽  
Gavin Morrison ◽  
Douglas D. Fraser
Keyword(s):  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Vascular Reactivity ◽  
Brain Infarction ◽  
Coagulation Factors ◽  
Children And Youth ◽  
Vascular Endothelial ◽  
Thrombotic Risk ◽  
Hemorrhagic Risk ◽  
Ischemic Brain Infarction

Diabetic ketoacidosis (DKA) is a state of severe insulin deficiency, either absolute or relative, resulting in hyperglycemia and ketonemia. Although possibly underappreciated, up to 10% of cases of intracerebral complications associated with an episode of DKA, and/or its treatment, in children and youth are due to hemorrhage or ischemic brain infarction. Systemic inflammation is present in DKA, with resultant vascular endothelial perturbation that may result in coagulopathy and increased hemorrhagic risk. Thrombotic risk during DKA is elevated by abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. DKA-associated cerebral edema may also predispose to ischemic injury and hemorrhage, though cases of stroke without concomitant cerebral edema have been identified. We review the current literature regarding the pathogenesis of stroke during an episode of DKA in children and youth.

Cerebral Oedema in Diabetic Ketoacidosis

1988 ◽  
Vol 33 (1) ◽  
pp. 212-213 ◽  
Author(s):  
D. Gordon ◽  
A. C. MacCuish
Keyword(s):  
Diabetic Ketoacidosis ◽  
Cerebrovascular Accident ◽  
Cerebral Oedema ◽  
Rare Complication ◽  
Fatal Outcome ◽  
Underlying Disease ◽  
Direct Result ◽  
Metabolic Decompensation ◽  
Metabolic Disturbances ◽  
Per Se

Modern management of diabetic ketoacidosis has reduced mortality of this condition from inevitable death in the pre-insulin era to less than 5% in specialised centres.1,2,3,4 Most fatalities now reflect the underlying disease which has caused metabolic decompensation, such as acute myocardial infarction, cerebrovascular accident or septicaemia.5 However patients may still die as a direct result of the metabolic disturbances per se and the rare complication of cerebral oedema in diabetic ketoacidosis is almost invariably associated with fatal outcome.6,7,8,9

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